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Vision and Hearing Impairment May Contribute to Depression in Seniors

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It is commonly known that hearing and vision impairment are much more pronounced in the elderly population. With the gradual onset of hearing and vision loss, certain tasks become more difficult for seniors.

In addition to the direct difficulties, such as having trouble reading smaller type or understanding conversations, hearing and vision loss is also associated with the development of mood disorders, according to Dennis Norman, Chief of Psychology at Massachusetts General Hospital.

"Vision and hearing loss are major public health issues because they affect so many older individuals, and because they have an adverse impact on mental health," says Norman. "If the senses are limited, everything is affected, including interaction with surroundings, relationships, activities, and feelings of self-worth. Impairment can lead to depression, anxiety, social isolation and many other problems."

According to the Centers for Disease Control, approximately 3.6 million Americans over the age of 70 have impaired vision, and 6.7 million older adults report impaired hearing.

The CDC also indicates that these individuals also are more likely to experience problems in other activities of daily life, such as walking, going outdoors, getting in and out of chairs or bed, or managing their prescription medications. They are also less likely to socialize than individuals without sensory impairment.

A recent study reported in Archives of Ophthalmology (April 2006) also suggests that there’s a significant link between visual problems and thinking, memory and learning.

Hearing impairment has also been linked to cognitive decline. Brandeis University researchers suggest that mental resources are expended toward efforts to hear, at the expense of memory.

Preventive Measures to Protect from Hearing and Vision Impairment

  • Wear sunglasses to reduce exposure to UV radiation
  • Protect ears by avoiding loud noises, wearing earplugs, and keep earphone volume down
  • Stay healthy with regular medical checkups, quitting smoking, and managing conditions such as diabetes and high blood pressure that can damage eyes and/or ears.
  • Maintain a healthful diet: Get plenty of vitamin C through citrus fruits and juices; eat carrots and dark-green leafy vegetables such as spinach for beta-carotene; eat whole grains, nuts, and eggs for vitamin E; and get needed zinc from fish, meats, whole grains and dairy products. For nutrients that strengthen or protect hearing, eat foods rich in: vitamin D (fortified dairy products, seafood, fortified cereals); vitamin B12 (meat, poultry, eggs, dairy products and shellfish); and folate (liver, eggs, beans, fortified cereals, leafy green vegetables, and fruits).
  • Consider supplements. Ask your doctor about taking supplements such as bilberry (huckleberry), ginkgo biloba and vinpocetine.

Helpful Resources
These groups offer support and information to help people cope with hearing and vision impairment:

Source: Newswise

Pregnancy After Breast Cancer

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While many women who go through breast cancer do so in their 50’s and are no longer considering childbirth, women who are treated for breast cancer at a younger age are often left wondering whether or not they will be able to have children afterwards.

Breast cancer treatments often involve chemotherapy regimens that can affect ovarian function, but according to Daniel F. Hayes, an M.D. and clinical director of the breast cancer oncology program at the University of Michigan, many women can still safely conceive after breast cancer treatments.

Fertility is certainly a concern for women undergoing breast cancer treatment and Dr. Hayes points out that fertility is definitely something that should be discussed before treatment. "That discussion is going to be specific for each patient," he notes, "because it depends how old she is, whether she should get chemotherapy, what kind of chemotherapy, and whether she cares about maintaining fertility."

Ovarian function can be affected by multiple factors in breast cancer treatment—particularly chemotherapy. While most chemotherapies negatively affect ovarian function, younger women have a better chance of regaining their periods after treatment than their older counterparts who may be closer to menopause.

Other therapies that affect fertility are the newer hormone-based therapies, which are often given for up to five years. To become pregnant, women would have to stop taking the hormone therapy for a period of time before conception. Dr. Hayes discourages this course however, because, he says, the benefits of the therapy are so great.

 Studies have shown that there should be little worry that breast cancer treatment therapies have an adverse effect on the newborn children. The risk of birth defects or miscarriages was not shown to be elevated among women who have undergone chemotherapy.

Some Breast Cancer Facts

  • Number of American breast cancer diagnosis in 2007: 180,510
  • U.S. deaths from breast cancer in 2007: 40,910
  • Breast cancer is the #3 leading cause of female deaths in the United States.
  • With early detection, breast cancer can be cured in 80 percent of women.
  • It is recommended that women over 50 get a mammogram every 12 months.
  • Never ignore a lump or change in the look or feel of your breast.

Deaths Linked to Cephalon’s Cancer Pain Drug, Fentora

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After receiving reports of deaths and other serious side effects, FDA is alerting consumers and health care professionals to concerns about the use of Fentora (fentanyl buccal) tablets, a potent opioid pain medication.

Fentora is used only for treating breakthrough pain in cancer patients receiving opioid treatment and who have become tolerant to it—those who take a regular, daily, around-the-clock narcotic pain medicine. Breakthrough pain is intense increases in pain that occur rapidly, even when opioid pain-control medication is being used.

People who develop tolerance to narcotic pain medicines are more resistant to the dangerous side effects of these medications than those who take narcotic pain medication less frequently.

The deaths reported indicate that some cancer patients

  • should not have been prescribed this medicine
  • were prescribed the wrong Fentora dose
  • took too many Fentora doses
  • received Fentora as a substitute for another fentanyl-containing product that is not equal to Fentora

Important Safety Information

  • Ask your doctor if you are opioid-tolerant before taking Fentora. The drug should only be used for breakthrough pain in opioid-tolerant patients with cancer.
  • Fentora should not be used to treat any type of short-term pain, including headaches or migraines, pain after an operation, or pain due to injury.
  • People who only take narcotic pain medications occasionally should not use Fentora.
  • Do not substitute Fentora for other fentanyl medicines, including Actiq. The dosage strength of fentanyl in Fentora is NOT equal to the same dosage strength of fentanyl in other fentanyl-containing products. Using the same dose can result in a fatal overdose.
  • Read the Medication Guide that comes with Fentora,and follow the directions exactly.

Watch For These Signs

Get medical attention right away if you have any of these signs:

  • trouble breathing or shallow breathing
  • tiredness, extreme sleepiness, or sedation
  • inability to think, talk, or walk normally
  • feeling faint, dizzy, or confused

FDA Actions

  • requested the manufacturer, Cephalon Inc., strengthen warnings and improve the dosing instructions in the drug’s product labeling and Medication Guide for patients
  • requested the company improve their education plan for prescribers and pharmacists
  • published a Public Health Advisory and Health Care Professional Sheet warning health care professionals that it is critical to follow Fentora’s product labeling
  • monitoring the Fentora issue closely and reviewing available information, including adverse events
  • working with the manufacturer to ensure the safest use of the medicine
  • providing updates as new information is available

Adverse events related to Fentora should be reported to MedWatch, the FDA’s voluntary reporting program.

Source: FDA

HPV Vaccine Not Effective for Treating Genital Warts in Women

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For women with human papillomavirus (HPV) infection, use of the HPV-16/18 vaccine will not accelerate reduction of the virus and should not be used to treat the infection, according to a study in the August 15, 2007 issue of JAMA.

HPV vaccines were designed to prevent HPV infection and the development of cervical precancers and cancer. Some research has suggested that HPV vaccines could help clear the virus in women already infected, according to background information in the article.

Allan Hildesheim, Ph.D., of the National Cancer Institute, Bethesda, Md., and colleagues conducted a study to address the question of whether women positive for HPV DNA should be encouraged to receive HPV-16/18 vaccination to induce or accelerate clearance of their infections. The trial was conducted in two provinces of Costa Rica and included 2,189 women age 18 to 25 years who were positive for HPV DNA. Participants were randomly assigned to receive three doses of HPV-16/18 vaccine (n = 1,088) or a control hepatitis A vaccine (n = 1,101) over 6 months.

There was no evidence that HPV vaccination significantly altered rates of viral clearance. At the 6-month visit, rates of clearance were 33.4 percent vs. 31.6 percent for HPV-16/18 among participants who received the HPV vaccine and the control vaccine, respectively. At the 12-month visit, rates of clearance among participants in the HPV group and the control group, respectively, were 48.8 percent vs. 49.8 percent for HPV-16/18.

There was no evidence of vaccine effects with further analysis on selected study entry characteristics reflective of disease extent, including HPV-16/18 antibody results, cytologic results, and HPV viral load. Similarly, no evidence of vaccine effects was observed in analyses stratified by other study entry parameters thought to potentially influence clearance rates and efficacy of the vaccine, including time since sexual initiation, oral contraceptive use, cigarette smoking, and concomitant infection with Chlamydia trachomatis or Neisseria gonorrhoeae.

"These findings have important clinical implications. For example, in countries where HPV DNA testing is incorporated in cervical cancer screening and prevention efforts, adult women who have abnormal Papanicolaou test results induced by HPV infection and/or who test positive for an oncogenic HPV type using the clinically available HC2 test might be interested in receiving the HPV vaccine to treat their existent infection," the authors write. "…our results demonstrate that in women positive for HPV DNA, HPV-16/18 vaccination does not accelerate clearance of the virus and should not be used for purposes of treating prevalent infections."


Source: JAMA. 2007;298(7):743-753.

Health Alert: Office Printer Dust May Pose Health Dangers

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Just when you thought that your office anti-smoking policy cleared the air in the workplace, a new study by Australian scientists suggests "not so fast."
Surveying numerous laser printers, the researchers discovered that approximately thirty percent release "dangerous" levels of very small toner-type material.

The particles are small enough (described as "ultra fine") that they can penetrate deep into the lung’s alveoli and create damage similar to the damage seen in inhaled cigarettes.

Of the 62 machines tested at the University of Queensland, 17 were classified as "high particle emitters."

Source: American Chemical Society’s Environmental Science and Technology Journal

Genes Linked to Multiple Sclerosis (MS)

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Researchers have published their discovery linking two genes with multiple sclerosis (MS).
Multiple sclerosis is an inflammatory disorder in which the immune cells infiltrate the brain and spinal cord.

Surrounding and protecting some brain and spinal cord cells is a fatty layer known as the myelin sheath. Myelin sheath is important for conducting electrical impulses along the nerves and maintaining the health of the nerves.
In multiple sclerosis, inflammation causes the myelin to degenerate and eventually disappear, causing the impulses that travel along the nerves to decelerate.

The researchers conducted a study using DNA technology that enabled them to screen the genetic blueprint of close to 3,000 people, 931 of whom had the disease.

The data revealed 174 nucleotide differences called single nucleotide polymorphisms (SNPs) that may be associated with the risk of multiple sclerosis. They then analyzed 110 out of the 174 SNPs in a second set of subjects which number close to 5,000 people. In their final combined analysis, the scientists cited several genes that showed significant association with the risk of multiple sclerosis, two of which are implicated in the regulation of the immune response–interleukin-2 receptor alpha gene (IL2RA) and interleukin-7 receptor alpha gene (IL7R).

Other associated genes include KIAA0350, RPL5, DBC1, CD58, ALK, FAM69A, ANKRD15, EVI5, KLRB1, CBLB and PDE4B.
The research was published in the August 2007 issue of the New England Journal of Medicine.

You Can Repay Your Sleep Debt

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6 out of 10 women get less than the recommended seven to nine hours of sleep at night. In due course, sleep debt piles up and affects their health.

A report published in Harvard Women’s Health Watch claims that this debt, however chronic or longstanding, can be repaid.
For instance, if you have a debt of 10 hours sleep, you can repay it by sleeping over the weekend and the week following it. If your sleep debt has piled up over decades, then it is advised that you take a short vacation to a place where you need not have a very busy schedule.

Ensure that you get proper sleep at night and wake up naturally in the morning—no alarm clocks allowed here. During the vacation, determine the amount of sleep you require and ensure that you get the determined amount of sleep everyday.

Source: Harvard Medical School

Menopause Pill Pristiq Fails to Get FDA Approval

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The Federal Drug Administration (FDA), in its letter to Wyeth—the manufacturer of the menopause Pill Pristiq—has outlined the need to perform at least one more year of clinical tests on the drug before it is aproved.

The FDA has called for more data on how Pristiq affects the heart and liver health of patients.
Wyeth, which is the largest manufacturer of hormone treatments today, has developed Pristiq to control menopausal symptoms such as night sweats and hot flashes and has forecast an annual revenue of $2 billion from the drug.

Decrease in Hormone Therapies Linked to Decline in Breast Cancer

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Researchers claim that an analysis of patients’ treatment records at a large HMO indicate that reduced use of hormone replacement therapy (HRT) may be the cause behind declining breast cancer rates.
They pointed out that, as some studies suggest, this decline is not due to reduced use of mammography.

The research indicates that one of the main causes of the decline is due to the reduction in post menopausal hormone therapy in 2003, in response to results of Women’s Health Initiative that linked breast cancer to hormone replacement therapy.

Growth of small tumors slows down when hormone replacement therapy is discontinued delaying discovery by almost two years. With the number of post menopausal estrogen and progestin prescriptions reduced to almost half, cancer rates have dropped by 7% in the year 2003.

Second Round High Dose Chemo May Cure Testicular Cancer

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Physicians from Indiana University report that increasing the dosage of anticancer drugs after the failure of first-line chemotherapy may lead to more succesful outcomes for men with testicular cancer.

The report published in the New England Journal of Medicine states that a considerable number of male patients with germ cell tumor are cured when they are treated with a second round of high dosage chemotherapy after the first round of chemotherapy has failed.

Unusual sensitivity of testicular cells to anticancer medicines is assumed to be behind these successful treatments. This treatment, however, cannot be extended to other types of cancers.